Our overall objective is to assess the role of environmental factors, including psychosocial and cultural, in the etiology and complications of diabetes mellitus. Both genetic and environmental factors are important in the pathogenesis and progression of diabetes. The proposed project will be a unique approach to epidemiologic research in diabetes, being performed in a genetically homogenous population--the greater Seattle area Japanese American community--for which sociocultural and demographic characteristics have been documented by us to an extent rarely available to those working in other populations. This population differs from most Euro-American populations in its genetic and cultural homogeneity, but has attained a socioeconomic profile similar to that of the United States white population. The specific objectives of this initial cross-sectional survey are: (1) to gain access to the population pool; (2) to examine in type II (non-insulin dependent) diabetes, the relationship of chronologic age, biologic age, blood pressure, adiposity, duration of diabetes, diet composition, use of alcohol or tobacco, physical activity, glycemic control, serum lipids, lifestyle, and social stress to the development of retinopathy, nephropathy, and neuropathy; (3) to examine the relationship of glycemia, chronologic age, biologic age, blood pressure, adiposity, diet, use of alcohol or tobacco, physical activity, serum lipids, lifestyle, and social stress to the occurrence of atherosclerotic disease. We plan to analyze our data in the context of the following questions: (1) Can discrete subgroups with different clinical, psychosocial and cultural characteristics be identified among diabetic individuals? (2) Are diabetic subjects prematurely aged? (3) What etiologic factors differentiate diabetic subjects from their nondiabetic siblings? (4) Are nondiabetic siblings of diabetic subjects different from nonrelated nondiabetic subjects? (5) What are identifiable risk factors for development of complications associated with diabetes? Although not specifically described in this proposal, we plan to later develop (1) a long-term, longitudinal, prospective survey in the same population, and (2) a comparison with native Japanese males in several locales in Japan.